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Updated: Jan 26, 2026

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Left atrial spontaneous echo contrast: relationship with clinical and echocardiographic parameters
Takahide Ito1, Michihiro Suwa2
1Department of Cardiology, Osaka Medical College, Takatsuki, Japan.
Insights
Spontaneous echo contrast (SEC) signifies blood stasis and can precede thrombus formation. Echocardiography helps identify patients at risk for thromboembolic events by assessing SEC in the left atrium.
Area of Science:
- Cardiology
- Vascular Biology
- Medical Imaging
Background:
- Spontaneous echo contrast (SEC) indicates blood stasis, a precursor to thrombus formation.
- Left atrial (LA) SEC detection via transesophageal echocardiography identifies patients at high risk for thromboembolic events.
- LA SEC occurs in sinus rhythm patients with heart failure and those with cardiovascular comorbidities, though mechanisms are unclear.
Purpose of the Study:
- To review the pathogenesis and assessment of SEC.
- To explore the relationship between LA SEC and clinical, biological, and echocardiographic parameters.
- To discuss the role of mitral regurgitation and blood coagulability in LA SEC.
Main Methods:
- Literature review of studies on spontaneous echo contrast.
- Analysis of echocardiographic findings, particularly transesophageal echocardiography for LA SEC.
- Examination of clinical, biological, and echocardiographic parameters associated with SEC.
Main Results:
- SEC is a marker of blood stasis and thrombus risk.
- LA SEC assessment is crucial for identifying thromboembolic risk.
- Factors influencing LA SEC include heart failure, comorbidities, and blood coagulability.
Conclusions:
- SEC assessment, especially in the LA, is vital for risk stratification.
- Further research is needed to elucidate the mechanisms linking comorbidities and LA SEC.
- Understanding SEC's role in various cardiac conditions can improve patient management.
Abstract:
Spontaneous echo contrast (SEC) indicates blood stasis in cardiac chambers and major vessels, and is a known precursor of thrombus formation. Transesophageal echocardiography plays a pivotal role in detecting and grading SEC in the left atrial (LA) cavity. Assessing LA SEC can identify patients at increased risk for thromboembolic events. LA SEC also develops in patients who have sinus rhythm, especially in those with heart failure. Detection of LA SEC is not uncommon in subjects who have multiple cardiovascular comorbidities, although mechanisms behind this association are not fully understood. In patients with atrial fibrillation, the role of mitral regurgitation in counteracting LA SEC and subsequent thromboembolism is controversial. Moreover, alterations of blood coagulability and elevated levels of certain biological markers in the blood contribute to occurrence of LA SEC. This review describes the pathogenesis and assessment of SEC, in addition to the relationship between LA SEC and clinical, biological and echocardiographic parameters.
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